Abstract
The wrist is among the predilection sites of over 90% of cases of rheumatoid arthritis (RA). In advanced cases, total wrist arthroplasty (TWA) is an alternative to arthrodesis. The aim of this study is to present the long-term results of the modular physiological wrist prosthesis (MPW®) and to match them in context with the results of a standard population survey. In a retrospective study with follow-up, patients with an MPW® endoprosthesis were evaluated concerning the clinical and radiological outcome, complications were reviewed (incidence and type), and conversion to wrist fusion was assessed. Patient function measurements included the Mayo wrist score, the patient-specific wrist test, and therefore the DASH score (arm, shoulder, and hand). Thirty-four MPW® wrist prostheses were implanted in 32 patients, including thirty primary implantations and four changes of the type of the endoprosthesis. Sixteen patients (18 prostheses) underwent clinical and radiological follow-up. The average follow-up time was 8.5 years (1 to 16). Poor results of the MPW prosthesis are caused by the issues of balancing with luxation and increased PE wear. Salvage procedures included revision of the TWA or fusion. In successful cases, the flexion and extension movement averaged 40 degrees. The grip force was around 2.5 kg. The common DASH score was 79 points, with limited and problematic joints of the upper extremity. The MPW wrist prosthesis offered good pain relief and functional movement in over 80% of cases. The issues of dislocation and increased PE wear prevent better long-term results, as do the joints affected. A follow-up study with fittings under a contemporary anti-rheumatic therapy with biologicals suggests increasing score results. Type of study/level of evidence: Case series, IV.
Highlights
More than 100 different diseases are counted among the diseases of the immune system, which are accompanied by inflammations of different body tissues and are mainly manifested in the articular and periarticular systems
The main outcome parameters were the survival rate of the MPW® prosthesis in situ; the number, temporal occurrence, and type of complications; the type of surgical revision; and the subjective patient satisfaction regarding the function of the prosthesis, as well as the suitability for daily use
None of the deceased had complications related to the arthroplasty or as a direct result of the underlying rheumatic disease up to the time of death
Summary
More than 100 different diseases are counted among the diseases of the immune system, which are accompanied by inflammations of different body tissues and are mainly manifested in the articular and periarticular systems. Of the population suffers from these diseases. Rheumatoid arthritis (RA) is the largest group, accounting for about 0.8% of the population. RA threatens to increase mortality within the first few years compared to most types of cancer but the chronic, inflammatory, and destructive course of the disease, combined with pain, severely restricts patients in their daily lives. RA often manifests itself primarily on the hands and wrists. Destruction of the wrists has been described in the progress of the disease in over 90% of patients. If surgical treatment is necessary, the preservation of residual mobility must be included in the planning, since arthrodesis of the wrist
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
